Association between moderate to severe atopic dermatitis and lifestyle factors in the Dutch general population

Background Studies on the association between severity of atopic dermatitis (AD) and lifestyle factors in adults have not been conducted in the Netherlands to date. Aim To explore the association between moderate to severe AD and lifestyle factors in adults in the Dutch general population. Methods We conducted this cross-sectional study within the Lifelines Cohort Study by sending a digital AD questionnaire to 135 950 adults in 2020. We extracted data on lifestyle factors from baseline, collected between 2006 and 2013. We analysed the association between lifestyle factors and presence of AD of any severity and of moderate to severe AD, using binary logistic regression and linear regression models. Results We enrolled 56 896 participants (mean age 55.8 years, 39.7% males). The lifetime prevalence of self-reported physician-diagnosed AD was 9.1%, and the point prevalence of any AD and of moderate to severe AD was 3.3% and 2.3%, respectively. We found that moderate to severe AD was associated with smoking habit of > 15 pack-years, alcohol consumption of > 2 drinks per day, chronic stress, Class I obesity, and both shorter and longer sleep duration. Moreover, we found dose-response associations with increases in smoking pack-years and level of chronic stress. We observed no associations with abdominal obesity, physical activity, diet quality or a vegetarian/vegan diet. Conclusion We found associations between moderate to severe AD and some modifiable lifestyle factors. Our findings indicate that more screening and counselling for lifestyle factors, particularly smoking, alcohol use, stress, obesity and sleep disturbances, appears warranted in patients with moderate to severe AD. Further longitudinal studies are required to better characterize the direction of these associations and to develop strategies for prevention

Validity, reliability, responsiveness and interpretability of the Recap of atopic eczema (RECAP) questionnaire

BACKGROUND: Limited research has been conducted on the measurement properties of the Recap of atopic eczema (RECAP) questionnaire, particularly in relation to interpretability. OBJECTIVES: To investigate the validity, reliability, responsiveness and interpretability of the Dutch RECAP in adults with atopic dermatitis (AD). METHODS: We conducted a prospective study in a Dutch tertiary hospital, recruiting adults with AD between June 2021 and December 2022. Patients completed the RECAP questionnaire, reference instruments and anchor questions at the following three timepoints: baseline, after 1-3 days and after 4-12 weeks. Hypotheses testing was used to investigate single-score validity and change-score validity (responsiveness). To assess reliability, both standard error of measurement (SEMagreement) and intraclass correlation coefficient (ICCagreement) were reported. To assess the interpretability of single scores, bands for eczema control were proposed. To investigate the interpretability of change scores, both smallest detectable change (SDC) and minimally important change (MIC) scores were determined. To estimate the MIC scores, four different anchor-based methods were employed: the mean change method, 95% limit cut-off point, receiver operating characteristic curve and predictive modelling. RESULTS: In total, 200 participants were included (57.5% male sex, mean age 38.5 years). Of the a priori hypotheses, 82% (single-score validity) and 59% (responsiveness) were confirmed. Known-group analyses showed differences in the RECAP scores between patient groups based on disease severity and impairment of the quality of life. The SEMagreement was 1.17 points and the ICCagreement was 0.988. The final banding was as follows: 0-1 (completely controlled); 2-5 (mostly controlled); 6-11 (moderately controlled); 12-19 (a little controlled); 20-28 (not at all controlled). Moreover, a single cut-off point of ≥ 6 was determined to identify patients whose AD is not under control. The SDC was 3.2 points, and the MIC value from the predictive modelling was 3.9 points. Neither floor nor ceiling effects were observed. CONCLUSIONS: The RECAP has good single-score validity, moderate responsiveness and excellent reliability. This study fills a gap in the interpretability of the RECAP. Our results indicate a threshold of ≥ 6 points to identify patients whose AD is 'not under control', while an improvement of ≥ 4 points represents a clinically important change. Given its endorsement by the Harmonising Outcome Measures for Eczema initiatives, the results of this study support the integration of RECAP into both routine clinical practice and research settings.</p

PL - 021 The research of High temperature exercise under different humidity environment effect on the body of water and salt metabolism

Objective Objective: This study was to investigate the body under high temperature (33 ℃) with different relative humidity (80%, 50%, 20%) combination of environment, respectively for 20 min 60% VO2max individual strength of quiet before and after the exposure of movement and under the same conditions, by measuring the participants within the body weight, serum sex hormone of blood, blood Na+、K+, Na+、K+ concentration in the urine of change, to explore in the sports stress and thermal stress of two kinds of stimulating the body water and salt metabolism characteristics, and to explore the effects of environmental humidity on the body's homeostasis. Methods Methods: This study selected 12 students of sports training major from Beijing sports university as subjects, with themselves as the control. The experiment is divided into six categories, respectively: high temperature 33℃ and 20% RH exposure group, the high temperature 33℃ and 20% RH campaign group, high temperature 33℃and 50% RH exposure group, the high temperature 33℃ and 50% RH campaign group, high temperature 33℃ and 80% RH exposure group and high temperature 33℃ and 80% RH. In this study all the environmental temperature are set up to 33℃, exercise intensity level of 60% VO2max selection for individual participants. Before every experiment, all participants were asked to quiet sit for 20 min and then measure the subjects' body weight, charge the subjects' vein blood and urine, take the same operation immediately after the experiment. Blood samples were stored at room temperature for 1 h, and 3000r/min was centrifuged for 20min. Serums were gathered through centrifugation, The urine and Serums were partial shipments in tube to be indicators of measurement. Serum Renin、ANGII、ALD、ADH、ANP、Na+、K+ concentration of serum and urine were tested Results Results:&nbsp; (1)The subjects' weight loss percentage of exercise group was obviously higher than that of quiet exposure group, the difference is statistically significant (P &lt; 0.01); In 80% RH environment weight loss percentage is significantly higher than that of 50% RH and 20% RH values (P &lt; 0.01).There is no difference between 20%RH and 50%RH. (2) The exercise group of Renin, ANGII, ALD, ADH, concentration is significantly higher than the value of exposed group (P &lt; 0.01), but the ANP concentrations were significantly lower than pure quiet exposure levels (P &lt; 0.01). Conclusions Conclusions: (1) The body sweat more after exercise than just quiet exposed in high temperature, weight loss phenomenon more obvious; And with the increase of relative humidity environment,&nbsp; dehydration will more serious. (2) Exercise factors can significantly promote the release of blood Renin, ANGII, ALD, ADH and&nbsp;&nbsp; inhibit the release of ANP in the blood. By the way of strengthening the absorption process of water and ions, it can maintain the body's balance of water and ions